Incontinence and Male GU Flashcards
a CYP17 inhibitor that selectively blocks androgen synthesis while increasing mineralocorticoid synthesis and decreasing glucocorticoid synthesis; unlike GnRH agonists/antagonists, it also suppresses adrenal synthesis of androgen
abiraterenone
neurotransmitter of the pelvic nerve that promotes bladder contraction
ACH
reduces sexual inhibitions but a frequent cause of male sexual dysfunction
alcohol
PGE1 formulation that can be injected into the corpus cavernosum or administered as a transurethral pellet to cause an erection
alprostadil
cell layer present in normal prostate glands that is absent in prostate cancer
basal
administered to augment the immune response against urothelial cancers to hopefully decrease the rate of recurrence
BCG
deformity in which the testes lies horizontally, carries an increased risk for testicular torsion
bell-clapper
antiandrogen that has become the drug of choice due to once daily dosing
bicalutamide
cigarette smoking, arylamine exposure and shistosome haematobrium are among the risk factors for this
bladder carcinoma
refers to androgen-sensitive periurethral nodules of prostrate stromal and epithelial cells that compress the urethra and can project into the bladder
BPH
aggressive testicular cancer, often causes no testicular enlargement; characterized by big multinucleated syncytiotrophoblasts and polygonal cytotrophoblasts with clear cytoplasm and one nucleolus, and hCG as a marker
choriocarcinoma
confers protection against penile squamous cell carcinoma, which is rare in US but has 10-20% incidence elsewhere (associated with HPV type 16 & 18)
circumcision
important complexer of calcium in the urine, low levels increase the risk of calcium stone formation; fruit juices are among the remedies
citrate
this of tamsulosin and dutasteride works better than either agent alone for treatment of BPH
combination
genital warts caused by HPV
condyloma acuminatum
failure of the testes to descend, has incidence of ~1% at 1 yr; carries increase risk of germ cell tumors
cryptorchidism
inflammation of the bladder, common in women of reproductive age
cystitis
GnRH antagonist, potentially the preferred choice for initial androgen ablation therapy since cost is comparable to GnRH agonists and it is able to suppress LH/FSH release without an initial surge
degarelix
abbr. for active form of testosterone in prostate, generated by 5-alpha-reductase
DHT
can be a consequence of BPH, this pouch-like evagination through the muscularis mucosa of the bladder is a site of urinary stasis and therefore prone to infection
diverticula
cytotoxic anticancer drug used to treat castration-resistant prostate cancer, inhibits mitosis
docetaxel
testicular carcinoma characterized by poorly demarcated cells arranged in alveolar/tubular patterns or sheets punctuated by foci with hemorrhage or necrosis
embryonal
uncommon malformation in which the urethra opens on the upper aspect of the penis, seen in association with bladder extrophy when the anterior abdominal wall fails to develop properly
epispadias
occurs in ~10 min when papaverine and phentolamine are self-injected into the corpus cavernosum
erection
unusual drug used as palliative therapy for advanced prostate cancer, it is comprised of estradiol and nitrogen mustard and concentrates in the prostate where it disrupts mitosis
estramustine
5-alpha-reductase inhibitor, suppression of DHT production treats BPH by causing regression f the prostate epithelial tissue that is compressing the urethra; side effects include gynecomastia
finasteride
increasing intake of this is the most important preventative measure against kidney stone formation for most people
fluids
antiandrogen used to block initial flare when GnRH agonists are administered to patients with advanced prostate cancer, also combined with GnRH antagonist to produce a “complete” androgen blockage when patients have failed to respond to GnRH agonist alone
flutamide
responsible for the vast majority of malignant testicular tumors
germcell
grading system used in prostate cancer, the sum of the two most common glandular patterns observed
gleason
loss of this, typically unilaterally, has been associated with PDE5 inhibitor use; the permanence of this loss is unclear
hearing
presumed precursor of prostate carcinoma, has normal architecture with patchy basal layer and cytological atypical secretory cells (i.e., have large nuclei with prominent nucleoli)
HGPIN
among the causes of hypercalciuria
hyperparathyroidism
population among elderly men who might derive additional benefit from use of a drug such as terazosin to treat BPH
hypertensives
among causes of this is chemotherapeutic treatment of malignancies
hyperuricosuria
high grade papillary urothelial carcinoma and carcinoma in situ are most likely to do this the bladder
invade
provides information on kidney stone size and location, if it is radiolucent or radiopaque, and information on calculus movement over time
KUB
GnRH agonist administered to desensitize the pituitary gland so that it does not secrete LH and FSH to stimulate testicular androgen production in patients with advanced prostate carcinoma; after an initial flare due to prostate stimulation it causes chemical castration
leuprolide
cells in testis stimulated by LH and FSH to secrete testosterone
leydig
rare testicular tumor, forms a circumscribed golden brown nodule that elaborates androgens and other steroid hormones; cells are large with eosinophiic cytoplasm and may contain Reinke crystals
leydig cell tumor
if a characteristic of prostate cancer, surgery and radiation are treatment options
localized
yellow lesions found in bladder of typically immunocompromised patients with a chronic infection, associated with macrophage accumulation and characteristic Michaelis-Gutmann bodies seen on H&E stained sections
malakoplakia
form of prostate cancer for which hormone deprivation therapy and chemotherapy are the only treatment options
metastatic
on the market since 2012, this beta3 agonist treats urge urinary incontinence by promoting relaxation of the detrusor muscle
mirabegron
characteristic of many urothelial bladder tumors at presentation
multifocal
refers to a rare but irreversible impairment of vision associated with the use of PDE5 inhibitors
NAION
neurotransmitter of hypogastric nerve that promotes bladder storage
NE
use of PDE5 inhibitors is absolutely contraindicate in patients treating angina with these drugs
nitrates
characteristic of prostate cancer disseminated to bone
osteoblastic
normally poorly absorbed from intestine, but absorption is markedly increased by inflammatory bowel disease and can contribute to stone formation unless chelated in the bowel by calcium or magnesium supplements
oxalate
an M3 selective antagonist, it is among the drugs in this class used to treat urge incontinence by blocking parasympathetic stimulation of the detrusor muscle
oxybutynin
perhaps the only symptom of urothelial carcinoma
painless hematuria
pathognomonic of prostate cancer
perineural invasion
DRE-palpable region of prostate that is site of majority of prostate cancer
peripheral
an erection lasting longer than 6 hrs, this is painful and can permanently damage the penis
priapism
normally a walnut-sized gland through which the urethra passes, composed of 70% glandular epithelial cells and 30% fibromuscular stromal cells
prostate
gritty/firm tan mass containing prostate glands lined with a single layer of epithelium
prostate adenocarcinoma
most common non-skin cancer in men, risk of developing is high during lifetime, but risk of dying from it is relatively low
prostate cancer
generally a result of poor bladder emptying or high pressure voiding due to BPH
prostatitis
promotes semen liquefaction, widely used to screen for prostate cancer but role is controversial
PSA
alpha adrenergic agonist that is a common OTC decongestant, it can increase urinary sphincter tone to decrease stress incontinence
pseudoephedrine
somatic nervous system nerve that contracts the external urinary sphincter
pudendal
extension of this from slightly above the iliac crest to the ipsilateral testis indicates the kidney stone is in the ureter
referred pain
rod-shaped structures found in leydig cells/tumors
Reinke crystals
probably more likely to be discovered now as an incidental finding on a radiograph than by the classic triad of flank pain, hematuria, and flank mass
renal mass
consequence of alpha-1a blockade in prostate
retrograde ejaculation
lymph nodes that are a common site of spread for testicular neoplasms
retroperitoneal
herbal remedy widely used to treat BPH, evidence of benefit is lacking
saw palmetto
contribute ~70% of ejaculate
seminal vesicles
most common germ cell tumor, presents as a painless testicular mass; cells are large and round/polyhedral with a distinct membrane, water-appearing cytoplasm, and a central nucleus with 1-2 prominent nucleoli, arranged in sheets with fibrous septations and lymphocyte infiltrates
seminoma
the nurse cells in the testes that support sperm production
sertoli
usually a hormonally silent benign testicular mass
sertoli cell tumor
phosphodiesterase type 5 inhibitor, it provides for a harder and longer-lasting erection by potentiating the effects of cGMP generated by sexual arousal
sildenafil
a very expensive customized therapy used to prolong the life of patients with hormone-refractory prostate cancer; macrophages are harvested and treated to express a prostate cell protein in their MHC surface molecule prior to readministration to patient to no trigger T-cell mediated killing of prostate cells
sipuleucelt
can occur in bladder due to injury/irritation
squamous metaplasia
class of drugs well-known for its adverse effects on sexual performance
SSRI
urinary incontinence due to inadequate containment by the urinary sphincter such that coughing, laughing, lifting heavy objects, etc. causes urine leakage; most common form of incontinence in women
stress
decreased when a urothelial bladder tumor has invaded into the muscularis propria
survival
alpha-1a subtype selective blocker that treats BPH by blocking constrictor tone of the fibromuscular portion of the prostate gland that could be impeding flow; doesn’t shrink prostate size; also used facilitate passage of kidney stones
tamsulosin
testicular tumor composed of a heterogeneous mix of differentiated cells including glands, cartilage, hair, bone/teeth, smooth muscle and squamous mucosa
teratoma
kept at a temperature 2-4 deg C cooler than core body temperature
testis
refers to twisting of the spermatic cord, causes abrupt/severe scrotal pain; a surgical emergency
torsion
zone of prostate that is site of benign prostatic hyperplasia
transitional
abbr. for gold standard surgical treatment of BPH, use is decreasing due to better pharmacologic treatment options
TURP
intrinsic causes of its potentially very painful obstruction include calculi, stricture and tumors while extrinsic causes include pregnancy and endometriosis
ureter
obstruction here is a congenital anomaly that is the most common cause of (typically unilateral) hydronephrosis in infants
ureteropelvic junction
urinary incontinence associated with hyperactivity of the detrusor muscle, treated with muscarinic antagonist and/or a beta3 agonist
urgency
kidney stones composed of this are more likely to form at low urine pH
uric acid
4-6 cell layers thick, it rests on a well-developed basement membrane, has a surface layer of large flattened “umbrella” cells, and is a frequent site of neoplasia
urothelium
site in addition to UPJ and crossing of iliac vessels where kidney stones are likely to become lodged
UVJ
more than 1 of these increases the risk of stress incontinence in women
vaginal delivery
common site of disseminated prostate cancer
vertebrae
testicular tumor most common in infants and young children, may contain Schiller-Duvall bodies (have mesodermal core with central capillary and visceral/parietal layers suggestive of primitive glomeruli)
yolksac
